REMINDER: I AM POSTING A NEW TOPIC ABOUT ONCE A WEEK OR PERHAPS TWICE A WEEK. HOWEVER, IF YOU DON'T FIND A NEW TOPIC POSTED, THERE ARE AS OF MARCH 2013 OVER 900 TOPIC THREADS TO WHICH YOU CAN READ AND WRITE COMMENTS. I WILL BE AWARE OF EACH COMMENTARY AND MAY COME BACK WITH A REPLY.
TO FIND A TOPIC OF INTEREST TO YOU ON THIS BLOG, SIMPLY TYPE IN THE NAME OR WORDS RELATED TO THE TOPIC IN THE FIELD IN THE LEFT HAND SIDE AT TOP OF THE PAGE AND THEN CLICK ON “SEARCH BLOG”. WITH WELL OVER 900 TOPICS, MOST ABOUT GENERAL OR SPECIFIC ETHICAL ISSUES BUT NOT NECESSARILY RELATED TO ANY SPECIFIC DATE OR EVENT, YOU SHOULD BE ABLE TO FIND WHAT YOU WANT. IF YOU DON’T PLEASE WRITE TO ME ON THE FEEDBACK THREAD OR BY E-MAIL DoktorMo@aol.com
IMPORTANT REQUEST TO ALL WHO COMMENT ON THIS BLOG: ALL COMMENTERS WHO WISH TO SIGN ON AS ANONYMOUS NEVERTHELESS PLEASE SIGN OFF AT THE END OF YOUR COMMENTS WITH A CONSISTENT PSEUDONYM NAME OR SOME INITIALS TO HELP MAINTAIN CONTINUITY AND NOT REQUIRE RESPONDERS TO LOOK UP THE DATE AND TIME OF THE POSTING TO DEFINE WHICH ANONYMOUS SAID WHAT. Thanks. ..Maurice
FEEDBACK,FEEDBACK,FEEDBACK! WRITE YOUR FEEDBACK ABOUT THIS BLOG, WHAT IS GOOD, POOR AND CONSTRUCTIVE SUGGESTIONS FOR IMPROVEMENT TO THIS FEEDBACK THREAD
"P in a Pod":(Physician Owned Distributorship): Physicians as Investors and Distributors in the Gadget Placed in Your Spine
If you have chronic back pain and
your doctor refers you to an orthopedic surgeon who tells you that he or she
can relieve the pain by inserting an appliance in your spine, there is a worry
that the surgeon may be offering the surgery mainly for the surgeon's financial
interest in that very appliance.
A POD is a
Physician Owned Distributorship. Under this business model, a doctor is an
investor in, and distributor of, the devices or hardware he may put into his
patients. Multiple doctors can have a financial interest in one POD.
business arrangement legal?
In and of
itself the arrangement is legal, but the Department of Health and Human
Services’ Office of Inspector General has concluded that PODs are “inherently
suspect under the anti-kickback statute.” It issued fraud alerts about PODs in
2006 and in 2013.
find out if my surgeon is involved in a POD?
your physician is under no legal obligation to disclose that information. The
Sunshine Act, a provision of the Affordable Care Act, does require that each year,
certain medical device makers and distributors disclose to the Centers for
Medicare and Medicaid Services ownership or investment interests held by
physicians or their immediate family members. The law requires the Centers to
post online the first batch of information it received by September.
‘Sunshine Act’ require my doctor to inform me that he is involved in a POD?
No. You will
have to ask on your own, or search that Centers for Medicare and Medicaid
Services website when it is published. The Centers say the site “will be
organized and designed to increase access to and knowledge about these
relationships and to provide information to enable consumers to make informed
Yes, there are laws preventing
physicians from referring their patients to facilities in which they own and
invest for laboratory services or procedures. The Federal regulations called
Stark (after Pete Stark, congressman who was its primary sponsor) can be
summarized as follows: A physician may not make a referral to an entity for the
provision of a designated health service (“DHS”) for which Medicare payment may
be made (and the entity may not present a claim for services provided as a
result of such a referral) if the physician or an immediate family member has a
financial relationship with the entity unless either the referral or the
financial relationship is “excepted” from the statute’s coverage. To read more about Stark regulations, here is
the link to a paper by Homchick and Looney which explains its current status.
Please read the excellent KPCC article about this unsettled and unsettling issue and then return back here and
write what you would you think about Physician Owned Distributorship and its
implications regarding providing the least expensive but the best in medical
care. Balancing the right of private
investment by any person versus the need for unbiased decision-making and care
by your physician, how do you size up POD, ethically, legally and if you were
the patient with that back pain and were told "I have just the operation
that can fix it"? ..Maurice.
Graphic: From Google Images and modified by me with ArtRage and Picasa3.